| Title: | The impact of margin status determined by the one-millimeter rule on tumor recurrence and survival following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma |
| Authors: | Nitta, Takeo Browse this author |
| Nakamura, Toru Browse this author →KAKEN DB |
| Mitsuhashi, Tomoko Browse this author →KAKEN DB |
| Asano, Toshimichi Browse this author |
| Okamura, Keisuke Browse this author |
| Tsuchikawa, Takahiro Browse this author →KAKEN DB |
| Tamoto, Eiji Browse this author |
| Murakami, Soichi Browse this author |
| Noji, Takehiro Browse this author →KAKEN DB |
| Kurashima, Yo Browse this author →KAKEN DB |
| Ebihara, Yuma Browse this author →KAKEN DB |
| Nakanishi, Yoshitsugu Browse this author |
| Shichinohe, Toshiaki Browse this author →KAKEN DB |
| Hirano, Satoshi Browse this author →KAKEN DB |
| Keywords: | Pancreatic ductal adenocarcinoma |
| Margin |
| 1-mm rule |
| TNM |
| Disease-free survival |
| Issue Date: | Apr-2017 |
| Publisher: | Springer |
| Journal Title: | Surgery today |
| Volume: | 47 |
| Issue: | 4 |
| Start Page: | 490 |
| End Page: | 497 |
| Publisher DOI: | 10.1007/s00595-016-1420-7 |
| PMID: | 27677294 |
| Abstract: | Purpose: The tumor-node-metastasis (TNM) classification defines R1 as the presence of tumor cells at the resection margin, while the current Royal College of Pathologists guidelines for pancreaticoduodenectomy specimens regard the presence of tumor cells within 1 mm from the resection margin as R1 (the "1-mm rule"). The aims of this study were to investigate the resection margin status of pancreatic head cancer retrospectively according to both the TNM and 1-mm rule classifications, and to evaluate the postoperative survival and tumor recurrence patterns. Methods: A total of 117 patients with pancreatic head cancer were the subjects of this study. Results: R1^1-mm rule resection was associated with a significantly worse disease-free survival (DFS) than R0^1-mm rule resection (p = 0.0259), while R1^TNM had no impact on DFS. R1^1-mm rule resection margin status correlated with the incidence of tumor recurrence in the liver (p = 0.0483). In a multivariate analysis, R1^1-mm rule resection was the independent variable for predicting poor DFS (hazard ratio 1.71; p = 0.0289). Conclusions: R1 resection margin status determined by the 1-mm rule may be an independent indicator for predicting disease recurrence, especially liver metastasis. These results may be useful for selecting the appropriate adjuvant therapy protocol and conducting strict surveillance in PDAC patients. |
| Rights: | The final publication is available at link.springer.com |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/68665 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
|
